Rectal suppository

Promoting an Optimal Response to Therapy If the patient is unable to retain the oral form of the drug, the nurse may give it parenterally or as a rectal suppository (if the prescribed drag is available in these forms). If only the oral form has been ordered and the patient is unable to retain the drag, the nurse contacts the primary health care provider regarding an order for a parenteral or suppository form of this or another antiemetic drag. 

If theophylline or anotiier xanthine derivative is given as a rectal suppository, the nurse checks die patient every 15 to 30 minutes to be sure die suppository has been retained. If the patient is unable to retain die suppository, die nurse contacts the primary health care provider because anodier route of administration may be necessary. 

Use the oral route of administration if the patient has mild nausea with minimal or no vomiting. Seek an alternative route (e.g., transdermal, rectal suppository, or parenteral) if the patient is unable to retain oral medications due to vomiting. 

Diazepam Being extremely lipophilic, diazepam penetrates quickly into the CNS, but can rapidly redistribute into body fat and muscle. This results in a faster decline in CNS levels and early recurrence of seizures. It is dosed at 5 to 10 mg (or 0.15 mg/kg) and infused no faster than 5 mg/minute. Repeated doses can be given every 5 minutes until seizure activity stops or toxicities are seen (e.g., respiratory depression). Diazepam can also be administered as a rectal suppository, making it possible for non-medical personnel to provide rapid therapy for seizures that develop at home or in public areas.11 The adult dose is 10 mg given rectally and this dose may be repeated once if necessary. Diazepam is erratically absorbed via the intramuscular route therefore, IM administration is not recommended. 

T, tablet C, capsule C-SR, controlled- or sustained-release I, injection L, liquid solution, elixir, or suspension LC, liquid concentrate, R, rectal suppository. 

Intestinal surface area and total blood flow to the GIT are smaller than in adults and may influence the efficiency of absorption. With regard to the use of rectal suppositories, one must keep in mind that the completeness of absorption will be a function of retention time in the rectum. Since bowel movements in... 

Other antiemetics Promethazine (Phenergan) 25 mg PO/IV/rectal suppository Q4H... 

C-ll, C-lll, C-IV, controlled substance schedule 2, 3, and 4, respectively cap, capsule chew tab, chewable tablet CINV, chemotherapy-induced nausea and vomiting liquid, oral syrup, concentrate, or suspension OTC, nonprescription Rx, prescription supp, rectal suppository tab, tablet. 

Rectal suppository (2 mg) with caffeine 100 mg Insert /2 to I suppository at onset repeat after 1 hour as needed... 

In general, NSAIDs with a long half-life are preferred as less frequent dosing is needed. Rectal suppositories and intramuscular (IM) ketorolac are options for patients with severe nausea and vomiting. 

The calculations involved here include determination of the amount of cocoa butter needed by using the displacement values as well as the amount of other ingredients. The calculations are shown in Examples 1-3. In this section, a brief overview is provided for the method of suppository preparation with cocoa butter. The first step is to decide whether cocoa butter is appropriate for the suppositories that are required to be prepared. If the use of cocoa butter is justified, the second step is to determine the weight of the suppository. Usually the adult rectal suppository with cocoa butter is 2 g, the children s suppository is 1 g, and the glycero-gelatin suppository for vagina is 5 g. The final step involves calculation of the amounts of all ingredients needed. 

Gertain drugs are administered as sublingual tablets (they are placed under the tongue) and as rectal suppositories these substances can be absorbed in the mouth and rectum, respectively. 

The inclusion of the a routine microbial limit test in a marketed product stability protocol depends on the pharmaceutical dosage form. Typically, the test would be used only for nonsterile products, especially oral liquids, nasal sprays, and topical liquids, lotions, and creams that have sufficient water activity to support the growth of microorganisms. In contrast, tablets, powder- and liquid-filled capsules, topical ointments, vaginal and rectal suppositories, nonaqueous liquids and inhalation aerosols with a water activity too low to allow for the product to support the growth of microorganisms would not be routinely tested. 

Acetaminophen (paracetamol) has good analgesic efficacy in toothaches and headaches, but is of little use in inflammatory and visceral pain. Its mechanism of action remains unclear. It can be administered orally or in the form of rectal suppositories (single dose,... 

Aminophylline rectal suppositories Irritation or infection of rectum or lower colon. 

Aspirin is available as capsules, tablets, enteric-coated tablets (Ecotrin), timed-release tablets (ZORprin), buffered tablets Ascriptin, Bufferin), and as rectal suppositories. Sodium salicylate is available genericaUy. Other salicylates include choline salicylate (Arthropan), choline magnesium trisalicylate (Trilisate), and magnesium salicylate Momentum). 

Treatment of constipation PO Initially, 5 mg/day. Rectal, enema One 1.25-oz bottle in a single daily dose. Rectal, suppository 5-10 mg/day. 

It is stimulant laxative, when administered orally or as a rectal suppository it produces increased peristalsis by direct action on the mucosa of the colon, usually resulting in a soft, formed stool. 

The hepatic first-pass effect can be avoided to a great extent by use of sublingual tablets and transdermal preparations and to a lesser extent by use of rectal suppositories. Sublingual absorption provides direct access to systemic—not portal—veins. The transdermal route offers the same advantage. Drugs absorbed from suppositories in the lower rectum enter vessels that drain into the inferior vena cava, thus bypassing the liver. However, suppositories tend to move upward in the rectum into a region where veins that lead to the liver predominate. Thus, only about 50% of a rectal dose can be assumed to bypass the liver. 

Of the xanthines, theophylline is the most effective bronchodilator, and it has been shown repeatedly both to relieve airflow obstruction in acute asthma and to reduce the severity of symptoms and time lost from work or school in patients with chronic asthma. Theophylline base is only slightly soluble in water, so it has been administered as several salts containing varying amounts of theophylline base. Most preparations are well absorbed from the gastrointestinal tract, but absorption of rectal suppositories is unreliable. 

A 0.1% ophthalmic preparation is recommended for prevention of postoperative ophthalmic inflammation and can be used after intraocular lens implantation and strabismus surgery. A topical gel containing 3% diclofenac is effective for solar keratoses. Diclofenac in rectal suppository form can be considered for preemptive analgesia and postoperative nausea. In Europe, diclofenac is also available as an oral mouthwash and for intramuscular administration. 

Metronidazole is a nitroimidazole antiprotozoal drug (see Chapter 52) that also has potent antibacterial activity against anaerobes, including bacteroides and Clostridium species. It is well absorbed after oral administration, is widely distributed in tissues, and reaches serum levels of 4-6 mcg/mL after a 250-mg oral dose. Metronidazole can also be given intravenously or by rectal suppository. The drug penetrates well into the cerebrospinal fluid and brain, reaching levels similar to those in serum. Metronidazole is metabolized in the liver and may accumulate in hepatic insufficiency. 

A change in the container closure system of unit dose packaging (e.g., blister packs) for nonsterile solid dosage fonn products, as long as the new package provides the same or better protective properties and any new primary packaging component materials have been used in and been in contact with CDER-approved products of the same type (e.g., solid oral dosage form, rectal suppository). 

Kosior, A. 2002. Investigation of physical and hypoglycaemic properties of rectal suppositories with chosen insulin. Acta Pol Pharm 59 353. 

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